Friday, August 18, 2006

ACTIVE LISTENING vs WORTHLESS DIPLOMATIC WRANGLING

Caroline Glick in the Jerusalem Post on just one of the coming wars that Israel and the west will have to cope with:

In the not so distant future, we will find ourselves at war with Iran. Today, the choice of whether we fight that war in our own time, and before Iran gets nuclear weapons is in our hands. If we hesitate, if we and the rest of the free world waste precious time with worthless diplomatic wrangling with the ayatollahs, war will come to us, but on the enemy's terms. And we will have only ourselves to blame.

You know, when I have a patient who tells me repeatedly that he is homicidal; and that he has the means to act on his homicidal fantasies; and that he intends to act on his homicidal fantasies--I usually don't just keep asking him if he is really serious.

I take him at his word. I take him very seriously. That is part of my job, and when I have evidence of either suicidal or homicidal intent, I must act.

Let me be perfectly clear: I don't like this responsibility. I don't like it at all.

However, I accept that it is one of the social control functions that psychiatrists are expected to perform by society at large. And I try to do my best--because I have it within my (admittedly limited) power to prevent it from happening. In my career, I have not always been successful at preventing a suicide or a homicide, but I always err on the side of caution when innocent life is at stake. I suppose it is grandiose, arrogant, and a lot of other things that I don't particularly admire.

But the bottom line is that if I did nothing, when I could have done something to try and prevent the tragedy-- I could not live with myself.

Taking action is even more imperative if there is a psychotic/delusional component; e.g., let's say that the homicidal individual believes that he is a special messenger of God who is destined to bring about the apocalypse and the return of some holy guy who disappeared hundreds of years earlier.

It would be tantamount to malpractice if I did nothing; or, if I simply made the homicidal person "promise" that he won't do anything stupid. Someone who is delusional to begin with is unlikely to be bothered by breaking a "promise" he thinks he needs to make in order to achieve his ends (and additionally wants to keep me from hospitalizing him).

When it comes to making the hard decisions to act and prevent homicidal countries, led by homicidal maniac leaders, from committing genocide, Glick has the right of it. All you have to do is listen to what the mullahs are saying. All you have to do is listen to what Ahmadinejad and the leaders of all the various Islamic fanatic cults are saying--repeatedly, clearly, concisely, calmly, and consciously.

They mean it. They have intent to do what they say. And all the wishful thinking and talking about "peace" and "brotherhood" and "common values" blah blah blah are denial disguised as diplomacy.